Creating an attractive workplace in healthcare is an issue many countries will try to resolve because of a global shortage of healthcare professionals. This study aimed to describe how healthcare staff in Estonia assessed appreciative management and its connection to the country and workplace in which they would choose to work outside Estonia. A quantitative descriptive study was conducted via an electronic survey among healthcare staff. Over half of the respondents (53.7%, n = 151) had no intention of leaving the workplace; over three of five (64.4%, n = 181) did not intend to leave the profession within a year. Systematic management, equality, and promotion of well-being at work were weakly connected to moving to another country. The more systematic management, equality, and promotion of well-being at work, the less the respondents considered moving. Appreciation of know- how had no statistically significant connection to considering moving to another country. In conclusion, only a few healthcare professionals were willing to leave their workplace or their profession. Appreciative management may be one issue to further promote workplace attractiveness and reduce turnover. The workplaces in healthcare are part of their country and environment, meaning their international reputation is important when one wonders where to live and work. This study implied that most of the healthcare professionals were willing to stay in their workplace and/or profession in Estonia, positively acknowledging which factor to base healthcare development on in Estonia.
1. WHO. Nursing and Midwifery 2020.
https://www.who.int/news-room/fact-sheets/detail/nursing-and-midwifery (accessed 2023-03-14).
2. OECD. Recent Trends in International Migration of Doctors, Nurses, and Medical Students 2019.
https://www.oecd-ilibrary.org/social-issues-migration-health/recent-trends-in-international-migration-of-doctors-nurses-and-medical-students_5ee49d97-en (accessed 2023-03-14).
3. Lopez, V., Anderson, J., West, S. and Cleary, M. Does the COVID-19 pandemic further impact nursing shortages? Issues Ment. Health Nurs., 2022, 43(3), 293–295.
https://doi.org/10.1080/01612840.2021.1977875
4. Stevanov, V., Sabo, S., Tomić, L., Mesarović, A., Kilíková, M., Sabo, A. and Tomić, Z. Why do nurses migrate? Abstract. Zdravotníctvo a sociálna práca, 2021, 16(1), 43–49.
https://www.ceeol.com/search/article-detail?id=958192
5. Primeau, M.-D., St-Pierre, I., Ortmann, J., Kilpatrick, K. and Covell, C. L. Correlates of career satisfaction in internationally educated nurses: a cross-sectional survey-based study. Int. J. Nurs. Stud., 2021, 117, 103899.
https://doi.org/10.1016/j.ijnurstu.2021.103899
6. Naim, M. F. and Lenkla, U. Knowledge sharing as an intervention for Gen Y employees’ intention to stay. Ind. Commer. Train., 2016, 48(3), 142–148.
https://doi.org/10.1108/ICT-01-2015-0011
7. Harmoinen, M., Niiranen, K., Niiranen, V., Åstedt-Kurki, P. and Suominen, T. Stories of management in the future according to young adults and young nurses. Contemp. Nurse, 2014, 47(1–2), 69–78.
https://doi.org/10.1080/10376178.2014.11081908
8. Harmoinen, M., Niiranen, V., Munnukka, J. and Suominen, T. Reliability and validity of a further tested appreciative management scale (AMS 2.0). J. Nurs. Meas., 2021, 29(1), 6–20.
https://doi.org/10.1891/JNM-D-19-00047
9. Jäppinen, K., Roos, M., Slater, P. and Suominen, T. Connection between nurse managers’ stress from workload and overall job stress, job satisfaction and practice environment in central hospitals: a cross-sectional study. Nord. J. Nurs. Res., 2021, 42(2), 109–116.
https://doi.org/10.1177/20571585211018607
10. Kol, E., Ilaslan, E. and Turkay, M. The effectiveness of strategies similar to the Magnet model to create positive work environments on nurse satisfaction. Int. J. Nurs. Pract., 2017, 23(4), e12557.
https://doi.org/10.1111/ijn.12557
11. Burmeister, E. A., Kalisch, B. J., Xie, B., Doumit, M. A. A., Eunjoo, L., Ferraresion, A. et al. Determinants of nurse absenteeism and intent to leave: an international study. J Nurs. Manag., 2019, 27(1), 143–153.
https://doi.org/10.1111/jonm.12659
12. Viinikainen, S., Rostila, I., Green, P., Asikainen, P., Helminen, M. and Suominen, T. The organizational social context in public healthcare as viewed by first-line nursing managers: a cross-sectional study. Nord. J. Nurs. Res., 2019, 40(2), 89–96.
https://doi.org/10.1177/2057158519878342
13. Kokkonen, A., Esaiasson, P. and Gilljam, M. Diverse workplaces and interethnic friendship formation – a multilevel comparison across 21 OECD countries. J. Ethn. Migr. Stud., 2015, 41(2), 284–305.
https://doi.org/10.1080/1369183X.2014.902300
14. Ahlstedt, C., Eriksson Lindvall, C., Holmström, I. K. and Muntlin Athlin, Å. What makes registered nurses remain in work? An ethnographic study. Int. J. Nurs. Stud., 2019, 89, 32–38.
https://doi.org/10.1016/j.ijnurstu.2018.09.008
15. Pursio, K., Kankkunen, P., Sanner-Stiehr, E. and Kvist, T. Professional autonomy in nursing: an integrative review. J. Nurs. Manag., 2021, 29(6), 1565–1577.
https://doi.org/10.1111/jonm.13282
16. Han, K., Trinkoff, A. M. and Gurses, A. P. Work-related factors, job satisfaction and intent to leave the current job among United States nurses. J. Clin. Nurs., 2015, 24(21–22), 3224–3232.
https://doi.org/10.1111/jocn.12987
17. Kultalahti, S. and Viitala, R. Generation Y – challenging clients for HRM. JMP, 2015, 30(1), 101–114.
https://doi.org/10.1108/JMP-08-2014-0230
18. Dall’Ora, C., Griffiths, P., Ball, J., Simon, M. and Aiken, L. H. Association of 12 h shifts and nurses’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ Open, 2015, 5(9), e008331.
http://dx.doi.org/10.1136/bmjopen-2015-008331
19. WMA. WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects. 2018.
https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/ (accessed 2023-03-14).
20. European Parliament. Interlinks Between Migration and Development. 2019.
https://www.europarl.europa.eu/RegData/etudes/BRIE/2019/630351/EPRS_BRI(2019)630351_EN.pdf (accessed 2023-05-16).
21. Lasater, K. B., Richards, M. R., Dandapani, N. K., Burns, L. R. and McHugh, M. D. Magnet hospital recognition in hospital systems over time. Health Care Manage. Rev., 2019, 44(1), 19–29.
http://dx.doi.org/10.1097/HMR.0000000000000167
22. Adelman, K. Promoting employee voice and upward communication in healthcare: the CEO’s influence. J. Healthc. Manag., 2012, 57(2), 133–147.
https://doi.org/10.1097/00115514-201203000-00009
23. Sayre, M. M., McNeese-Smith, D., Leach, L. S. and Phillips, L. R. An educational intervention to increase “speaking-up” behaviors in nurses and improve patient safety. J. Nurs. Care Qual., 2012, 27(2), 154–160.
https://doi.org/10.1097/NCQ.0b013e318241d9ff
24. Nurmeksela, A., Zedreck Gonzalez, J. F., Kinnunen, J. and Kvist, T. Components of the Magnet® model provide structure for the future vision of nurse managers’ work: a qualitative perspective of nurse managers. J. Nurs. Manag., 2021, 29(7), 2028–2036.
https://doi.org/10.1111/jonm.13337
25. Steinmetz, S., de Vries, D. H. and Tijdens, K. G. Should I stay or should I go? The impact of working time and wages on retention in the health workforce. Hum. Resour. Health, 2014, 12, 23
http://www.human-resources-health.com/content/12/1/23
https://doi.org/10.1186/1478-4491-12-23
26. Official Statistics of Finland (OSF). Structure of Earnings 2016.
https://www.stat.fi/til/pra/2016/pra_2016_2017-09-21_tie_001_en.html?ad=notify (accessed 2023-03-14).
27. Statistikaamet. Statistika andmebaas 2022 (Statistical Database 2022)
https://andmed.stat.ee/et/stat/majandus__palk-ja-toojeukulu__vabad-ametikohad/PAV011 (in Estonian) (accessed 2023-03-14).
28. Lisney, J. 2021. Youth Progress Report 2021.
https://www.youthforum.org/files/YPI20202120Full20Report.pdf (accessed 2023-08-10).
29. Harmoinen, M. and Suominen, T. Realizing appreciative management from the viewpoint of first‐line managers in social and health care. Scand. J. Caring Sc., 2020, 34(1), 78–86.
https://doi.org/10.1111/scs.12707
30. DeVellis, R. F. Scale Development. Theory and Applications. Sage, 2012.